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Mary Jo Barrett, MSW - Guest
Mary Jo Barrett, MSW is the author of Incest: A Multiple Systems Perspective and Treating Complex Trauma: A Relational Blueprint for Collaboration and Change (Psychosocial Stress Series). She is also the Executive Director and co-founder of The Center for Contextual Change, Ltd. and in the past has been on the faculties of University of Chicago, School of Social Service Administration, The Chicago Center For Family Health, and the Family Institute of Northwestern University. Mary Jo was the Director of Midwest Family Resource and has been working in the field of family violence since 1974. She focuses on the teaching of the Collaborative Change Model, systemic and feminist treatment of women, adult survivors of sexual abuse and trauma, eating disorders, couples therapy, Post Traumatic Stress Disorder, and compassion fatigue. |
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W. Keith Sutton, Psy.D. - Host
Dr. Sutton has always had an interest in learning from multiple theoretical perspectives, and keeping up to date on innovations and integrations. He is interested in the development of ideas, and using research to show effectiveness in treatment and refine treatments. In 2009 he started the Institute for the Advancement of Psychotherapy, providing a one-way mirror training in family therapy with James Keim, LCSW. Next, he added a trainer and one-way mirror training in Cognitive Behavioral Therapy, and an additional trainer and mirror in Emotionally Focused Couples Therapy. The participants enjoyed analyzing cases, keeping each other up to date on research, and discussing what they were learning. This focus on integrating and evolving their approaches to helping children, adolescents, families, couples, and individuals lead to the Institute for the Advancement of Psychotherapy's training program for therapists, and its group practice of like-minded clinicians who were dedicated to learning, innovating, and advancing the field of psychotherapy. Our podcast, Therapy on the Cutting Edge, is an extension of this wish to learn, integrate, stay up to date, and share this passion for the advancement of the field with other practitioners. |
Dr. Keith Sutton, Psy.D: (00:21)
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advancements in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy. Today I'll be speaking with Mary Jo Barrett, who's a social worker and is the author of Incest, A multiple systems perspective and Treating Complex Trauma, a relational blueprint for collaboration and change. She's also the executive director and co-founder of the Center for Contextual Change, and in the past has been on the faculties of the University of Chicago School of Social Service Administration, the Chicago Center for Family Health, and the Family Institute of Northwestern University. Mary Jo was the director of the Midwest Family Resource and has been working in the field of family violence since 1974. She focuses on the teaching of the collaborative stage model, systemic and feminist treatment of women, adult survivors of sexual abuse and trauma eating disorders, couple therapy, post-traumatic stress disorder, and compassion fatigue. Let's listen to the interview. Hi Mary Jo. Thank you for joining us today.
Mary Jo Barrett, MSW: (01:31)
Hello, how are you?
Dr. Keith Sutton, Psy.D: (01:33)
Good. So I know of your work. I think, gosh, we had run into each other at the AFTA American Family Therapy Academy conference, and I know Jim Keim, a colleague of mine, has spoken highly of your work. And we ended up chatting and, you know, actually coordinating for you to go out. My, my mother was living and doing work in Zanzibar and you went out and did some work there and did some training in with folks in mental health and around child abuse and things like that. And so yeah, I reached out because I, I know you're doing some wonderful work and I'd love to hear about, you know, your work and what you've been up to lately. But first let's start off, and I, I'd always love to find out about kind of folks' careers and kind of how they got into doing what they're doing and their evolution of thinking.
Mary Jo Barrett, MSW: (02:24)
Yep. So that's a really good question for me because mine's so straightforward I think. Yeah. So Keith, I've been in the field for probably well over 40 years, and what's interesting is just in terms of thinking, I was an undergraduate and it was at Northwestern and it was before family therapy and I majored in community psych. Which is not even a big thing that much now probably, people can't even major in it, I don't know. And so I majored in community psych and my emphasis, kind of a thesis kind of thing but not really, was on child abuse. So I've done nothing else but interpersonal violence since I was 21. And I would say it was by chance, that piece, of course nothing's totally by chance as we know. But the other piece that I think was really influential is that I, right out of social work, right out of social work, social work graduate school. So that was 1978 and the child abuse law only came into being in 1976 around. I was the first, I worked at the agency that was the first in-home counseling agency for the Department of Children Family Service on a child abuse and neglect cases. So basically in the state of Illinois, I was the first in-home counselor for abuse and neglect. And, at some point, I mean, I won't tell you the whole story but if you ever wanna listen to my story of my first very first client. But my very first client was a Chicago cop who was abusive to everybody in his family in some way. And so, the piece is that I was there sitting in the family, in the home, and kind of having no idea what to do. You know, I mean, there was no training. There was no teaching. And as time went by, it became really clear to me that I couldn't just work with the child who was still living in the home. I couldn't just work with the parents. I had to do more in terms of the family. So I went back for postgraduate in family therapy because it's the only thing that made sense to me. And what was also really interesting is that when I went back, and you're familiar with all the names, I did a lot of training with Carl Whitaker because he's a Midwest guy, I'm a Midwest gal. And I would call in with him talking about these incest cases or child abuse and he, because what a wonderful, lovely person he is would say to me, “Hey, I know schizophrenia and families. And I know systems thinking, but you are” and he literally at one point said to me, which is a good mentor, “You are gonna have to be the one that figures out systemic thinking for violence in a family. That's your generation, you’re next.” And, which just sort of reminds me that in some ways this podcast, I'm speaking to the next generation, like he spoke to me. Which we'll get to later. So that's how I came into it. And I, being a family therapist, one of the ways that I literally taught myself on how to do this was studying family therapy for sure. Also I spent a lot of time asking families. Okay. Just like we all know as family therapists, you're the expert, so teach me. What do you, what help do you need as a family where there's violence, where there's incest, where there's sexual abuse? And to this day, I'm still saying that to families.
Dr. Keith Sutton, Psy.D: (06:56)
Approaching and really learning from their knowledge.
Mary Jo Barrett, MSW: (07:00)
Right. And even to the point of every session, what out of this session worked? What didn't, what do you need? Where are we going? And because of what I learned, I developed a model called the collaborative change model. Which is a meta model. It's not intervention based. It's concept based and it's about how to. There's two major concepts in the model, which is how to collaborate and integrate your therapist. Not as us doing something to them. The hierarchy, the issues, hierarchy and attachment, which are paramount in therapeutic relationships. Those are the same issues in interpersonal violence. Hierarchy and attachment. So the importance is, for us as therapists, not to be doing something to the client. That it's collaborative, which abuse is not. Abuse is not a collaborative endeavor. So what we want in a relationship of hierarchy and attachment is to collaborate. So that's one essence of the collaborative change model. The other sort of guiding factor is timing. I always say to students, I'm teaching, you gotta look at good therapy like good comedy, which is timing is everything. And so this metaconcept is about timing in sessions. When do you do what, how do you recognize what's going on in the room? How do you change direction? When do you, how do you collaborate? It's all about stepping back and having an awareness of what's going on in the system in the room at the moment. So those are old family therapy getting enactments, but the difference is, we have an enactment, or I'm creating a crisis. How do I time that?
Dr. Keith Sutton, Psy.D:(09:12)
To kind of be more successful.
Mary Jo Barrett, MSW: (09:14)
Yeah. So those are the two pieces of the collaborative change model. And they're the two things I learned by asking thousands of clients what works. What therapy have you done in the past that didn't work?
Dr. Keith Sutton, Psy.D: (09:28)
Can you tell me a little more about this timing? Is it kind of like, first you wanna achieve this and then that or so on? Or is it a felt sense? It sounds like you've got a roadmap of where we are and what we need to do next.
Mary Jo Barrett, MSW: (09:44)
The book is called the blueprint for, it's the blueprint for collaboration and change. It's literally a blueprint. And it's based, Keith, on the natural process for change. Meaning not Mary Jo Barrett's natural, but the universes’. Like how seasons go, how the trees go, how day and night goes. It's a rhythm of what I call contraction and expansion. So it's, it's a felt sense and it's a cognitive sense. I mean, it kind of reflects the whole body. And so it's a felt sense in the room what's happening with me as a therapist with the client and perhaps in our interaction. Is this the moment I need to contract? Do we need to, it's basically do we need to lower the nervous system? Do we need to get re-grounded? Do we need to get refocused? Do we need to take time? Then, when a felt sense, but also a cognitive sense by me saying, hey Keith, are you ready to move on? Where are you at? Are you with me? Do I have permission to ask this question? Can we go forward? Then, it's a challenge, which I consider an expansion. So then I push, I do one of the interviews in intervention I might know from IFS or EMDR or whatever. And then I watch. See where it landed, you know, see where it's at. Do I contract? And so there's a rhythm. Now if you have read, and I'm sure all your listeners are completely steeped in neuroscience now, what's interesting is Bruce Perry who's very involved. I mean his you know, complex trauma, he's the king. He talks about the brain needing a rhythm. That the brain needs this rhythm. That's why, you know, music, walking, like eMDR is a rhythmic thing. And I, I heard him say this after, obviously I developed a collaborative change model. But then it made sense to me that this rhythm I'm talking about in session and over time is soothing.
Dr. Keith Sutton, Psy.D: (12:19)
Yeah. Well, it sounds like you're really kind of also providing that co-regulation. Like kind of helping to regulate and ground and contain and hold, and then kind of helping the person then kind of go outside of their comfort zone and creating some change or creating some crisis or enactment or, you know, kind of going into a discomfort and, and potentially even leading to something that might change a paradigm and then kind of holding that.
Mary Jo Barrett, MSW: (12:50)
Exactly. And it could happen 10 times in a session, and it happens over time. So it's both a macro and a micro. I think the one thing that I wanna say is that you're absolutely right. You described it perfectly. Beautiful summary consolidation. I teach this to my clients. That's the goal again. So when the client first comes in I say, so here's the rhythm we're gonna go for. So when I stop, this is why I'm stopping. When I pause and I ask you questions, I teach them intro to polyvagal, and then I talk about how that's gonna happen in a session, how it's also gonna happen outside. That's why I like having family members, because I teach them together how to co-regulate these concepts. Like I, I'm very, very, very involved in working with people who are gang affiliated on the South side of Chicago. I'm sort of going back to my roots. I started on the south side of Chicago in violent interpersonal violence. But if you came, I mean, that whole program we could talk about when you wanna know about what I'm currently doing. But, if you came to any of our groups, or what we do, these retreats, you'd think they all went to UFC in neuroscience. They talk brain all the time. They talk about, they call different parts of their brains different things, but they talk about trauma, mind state. They talk about this rhythm because as soon as I've created relationships with them or any of the other staff, then the next step is this part of really explaining to them the process of change.
Dr. Keith Sutton, Psy.D: (14:53)
Yeah. Well, and it's so important when working with someone, I mean, anyone in general, but especially somebody who has experienced complex trauma and really being very transparent and collaborative. You know, sometimes I tell my clients, hey, you're the captain of the ship. Kind of deciding where we go so that there is a feeling, a sense of control, and feeling kind of safe and being able to speak up and so on and know what's going on here rather than feeling like, you know, the therapist is doing something and feeling fear about what this person is doing. And so, it sounds like you're really kind of communicating that every step along the way of letting them into what you know and what you're thinking and so on. And really kind of walking together.
Mary Jo Barrett, MSW:(15:37)
Right. The four major themes or the four major impacts of interpersonal violence, which has come to be called complex trauma, although I still think the majority of what we're talking about that comes into our office is usually violations or neglect. And, is that when that happens over the lifespan it leaves a person powerless, out of control, devalued, and disconnected. Our therapy, each and every moment as much as we can, and each and every
session should be empowering. Having people feel in control, having people feel valued, and having people feel connected. So how you do that, there's lots of variations and it can be your own personality and your own model. Yet those are, can you look back at any second in a session, I should be able to look back and say, oh, Keith, that was real. You just gave, that was great. They were empowered, you valued them. It's something that has to be overarching. Is helping establish power, control, connection, value.
Dr. Keith Sutton, Psy.D: (16:58)
Definitely. Now you're, you know, I think for many people when they would think about working with a child who had experienced incest or working with violence in the home or so on, oftentimes people would think, oh no, you can't do family or couples therapy with that type of situation. You can only do individual work. Tell me about your thinking around this.
Mary Jo Barrett, MSW: (17:22)
Well, okay. So my thinking is, again, it goes back to timing. There is that when you bring people in the room together and how you bring people in the room together varies. You know, so like, domestic violence might be different than incest. I get it's also about living together. I mean, even if people are still living together, what's the sense of risk? So, in what I call the first phase, which is creating a context, I mean they're all named. Like creating a context for change, my initial say is assessment, safety assessment. And so I don't necessarily bring everybody together in the room If I assess it's not safe. However, I will try to coordinate getting everybody in the process. And knowing that there's timing. So if there's domestic violence but they're still living together, then I will say we will do couples. But we're not gonna do couples until I get to know both of you and can assess the assessment. So I do couples for domestic violence, it's again when. If it's incest and there's divorce but the child still sees the father or wants to see them, usually they won't see them. Then it's a matter of getting the father in therapy into an offender program to work on his denial. But we're all knowing that perhaps in phase two, which I call challenging patterns and expanding realities, that it will happen. So the goal is we will eventually do or be in interaction with each other. Because very few families are completely cut off, right? And so that's one thing. The other piece is that when a survivor calls me, one of my first questions, are you married? Do you live with someone? Do you have children? And if they say yes, again, I introduce the concept. I don't know when, but the family will be together. Now, if they're married, I will probably ask immediately to see the partner. If they're living together. So it, it's again, it's about timing. There will be family sessions and it's a collaborative effort to when that will happen. And most of the time, the clients want family therapy. They're not reactive when I say it. They know they're in relationships and they know their relationships are suffering. That it's, it's really societal, and it's our culture. I think as therapists that we've looked at adult survivors with individual models.
But they don't, they don't live alone.
Dr. Keith Sutton, Psy.D: (20:53)
So it sounds like, as you're saying, listening to the clients and finding out what they need, we were chatting about this before we got started, that they're, the clients are telling you that they want To do this work or feeling, or you were even mentioning a client earlier today was saying, I feel like I need to address this with my parents to really heal.
Mary Jo Barrett, MSW: (21:15)
Yeah. And that's four or five years into the therapy, not just with me, with other people. Yeah. But they've, you know, four or five years they're saying, okay, now it's, I think it's time for my next stage. So to me, when I say timing over timing, I mean, you know, when someone says to me, I'm ready, I need to have a conversation with my parents. To me, they're in stage two now. They've been in stage two for other things in their life, they're even, they probably have consolidated things. Like right now, this particular client's doing great. Has life, sees people, makes money, is totally functioning. So because they've consolidated part of their healing now they're ready to do this next challenge. And, I get a lot of those referrals. So I'm not saying that individual is a terrible thing. I think people do a lot of healing. I'm just saying it's not enough.
Dr. Keith Sutton, Psy.D: (22:20)
So I know you have particular thoughts about the relationship between the therapists and the client and some elements that lead to success in therapy and that are essential. Could you talk a little bit about those aspects?
Mary Jo Barrett, MSW:(22:34)
Okay. Yeah. So what we did, Keith, is, and, and it wasn't just me. It's been all over wherever I've taught, or anyone that's been trained in the CCM, the collaborative change model, is that we've asked people what was the important ingredients. Like what happened in this session that was really helpful. If we're talking at the end of the session, what are you feeling right now? And we would ask that periodically, like, how is therapy going? Are we meeting your goals? Let's look at the goals you first brought up when you first came in, or do you feel like our sessions are meeting it? So it's this constant, and if you, you know, think about the collaborative change model, It's a constant consolidation. So we consolidate before we create a context, so checking in, where are you at? And what we discerned were these five, that there were five essential ingredients that had to happen throughout therapy and in every session and throughout the session. So those five things, and then I'm gonna talk a little bit about the therapist on self in relation, is that the first thing the client said which we all know right? Was the relationship with the clinician. I mean, we all know that there's been tons of research, tons of articles. But what we know, what the clients told us in their own words is that it was the relationship. And the relationship was more than just I liked my therapist, or I thought my therapist was smart. It was they really had a sense that their clinician, their therapist, was curious, compassionate, and empathetic. And that they were good human beings. So to me it was connecting them that they really thought the values of the clinician were good, and that the clinician also had a vision of the future. Whether that meant a vision of what we're gonna do here in therapy, this is how this works. But it was also a vision of how the client was going to be. Right? And the other thing they said, which is, was necessary, and this is what they said, which is the argument for systems, is that they found the sessions with their family members in the room some of the most essential. Whether it was an adult survivor who said that session with my mother, or the adult survivor I saw just yesterday who had a session with her brother who had sexually abused her. She only had three sessions, but she said those were the, some of the most essential. Working on marriages, working on parenting. You know, like the couple I saw earlier came in with a huge fight, and it was obviously, as you and I know, around how they can parent better together. So, and this was somebody who had only had individual therapy for their dysregulation. So what? So that's the first piece, is the work, the attachment with the therapist, but also their relationships in their lives where there was more empathy and compassion and curiosity created. Do you wanna ask about that?
Dr. Keith Sutton, Psy.D:(26:32)
Well, I was gonna say, you know, you were mentioning earlier about the Scott Miller work and the feedback informed treatment. And the way I think about it, oftentimes it's about attunement. Also about kind of attuning to our clients asking for feedback directly and noticing, you know, what we're getting kind of non-verbally and so on throughout the sessions to maintain that connection. And kind of moving together, rather than getting ahead of our clients or pulling them along or pushing or so on.
Mary Jo Barrett, MSW: (26:59)
Yeah. And if I don't address those exact words in a minute, remind me about it. The second thing that the clients told us was about safety and empowerment. And again, we all know this about trauma, but what does that mean in their words? Is that they had to feel safe in the relationship? And the relationship with the clinician was they had to have clear boundaries. It had to be predictable. They had to understand the process. Like, why is this, why are we doing this now? How does therapy work? And they had to recognize that the clinician was gonna help them feel safe in their relationships with their family, not just in the room again. Like yesterday I was, or the other day I was seeing a client who was, the kid was saying to me I don't feel safe. And what they were talking about is how their parents were handling covid. And that word that the importance in the session became, how can we help you feel safe at home? So that whole thing, and the empowerment comes by again, asking the clients, right? Getting informed of what the clients need. That's empowerment. The third thing the client said is they had to feel valued. They had to, they had the, that again it's a conscious effort on the therapist. Is the client feeling valued with how I'm treating them? Am I saying things that are, again as we as family therapists know, are strength based? Am I really utilizing their resources and their strengths in how I'm designing the therapy? Am I commenting on their strengths? Am I, can I look at myself and say, how do I value this crime? You know, I think, I don't know, I think I told you about my first client, the police officer. Maybe I didn't. But when I interviewed the mom 40 years later the father who had been the victim, I mean the father who had been the abuser had died. And I interviewed them 40 years after I had first seen them. They were my first client. It was pretty remarkable. And the mom, when I said to her, do you remember that session when I made the home visit? And everybody was throwing glass at each other when I walked in? And she said, yes. And I said that was huge in my career. What, how do you remember it? And she said, I remember that session as you were the first person who ever had faith in me. And I was a 24 year old, 25 year old social worker that had no clue what I was doing, had walked in when people were literally throwing glasses at each other. And somehow whatever I did made her feel and that she remembered 40 years.
So that's again, that sense of feeling value.
Dr. Keith Sutton, Psy.D: (30:28)
Well, I think too, that oftentimes, when the client experiences the therapist as seeing the person in them that they want to be, or that they are becoming, or they're kind of the part of them that they really appreciate rather than just their problem. That oftentimes feeling that connection and more of that hope. I think too that this aspect is valued. Jim Keim, my colleague, we discussed family therapy at times and he talked about, you know, how important it is to have empathy and value for your clients. And that he always recommends working with sex offenders, because he says it will really challenge your ability to be empathic and, you know, to really find something that's likable and valuable in your client, even though maybe they engaged in these horrific acts. I don't know if you have any thoughts on that.
Mary Jo Barrett, MSW: (31:21)
Yeah I mean, that's, you know, because I work with a lot of offenders, it is about finding something you value in them. I mean, and sometimes if I can't, then I have to figure out, how do I help them find somebody that can value them. Although when I very consciously say, this is what I'm doing right now, is to look really hard at what I can value about them. And that's where my questions are. I usually find something. But they, but the client said they needed to feel valued. So the fourth thing they said was skills. Literally psychoeducation. So all those things, even though I keep saying, let's not be intervention oriented, let's be more meta oriented, they do need skills. And they said that learning how to meditate, learning good communication, learning self-regulation, and again, going to the systems piece is that they said if everybody was learning the same mindfulness, it was helpful then if I learned how to regulate and went home to a dysregulated house. So again, I have all sorts of handouts where I try to teach people about the polyvagal, about, you know, they’re very understandable worksheets. And it's important for everybody in the family to know. So, the last thing they said was hope. And that was that the clinician really did believe one; that what they're doing was gonna be helpful and could work. And two; that they had hope and that they instilled hope in the process and in the context. And one of the things that I go for at the end of the session is, how are you feeling right now? And I'm looking for those words of, this was helpful. This was helpful. This made sense to me. I'm looking for words of regulations. You know, social engagement. I'm, and what I'm saying about I believe these ingredients are, is that we need to be conscious of them. They should be a checklist. I should be able to walk into any session, any clinician, and take that snapshot of that moment and see in that relationship at least one, two, or three in that moment of these happen in one way or another.
Dr. Keith Sutton, Psy.D:(34:37)
Yeah. Because otherwise all the processes or techniques or stages or so on are, you know, not gonna do much if you don't have that relationship. And then you end up kind of having the therapist pulling along the client or pushing them along or so on and getting frustrated. And getting into kind of seeing them as quote unquote “resistant.”
Mary Jo Barrett, MSW: (34:58)
Right. Exactly. Exactly. Now, which then goes on to the next piece is that all of us need these five essential ingredients. In our lives to stay what I call ethically attuned. I think it's an ethical imperative for therapists to be fit. And, and when I say fit that, it means how are these five things happening in my life? Do I feel valued in my own life? Do I practice my skills or no skills? Do I feel, what is my, who am I attached with? What's my social engagement? Do I have friends? How am I, what's my spiritual essence? And so, to me, in order to do these five ingredients or integrate them into the treatment, we have to be also ethically attuned ourselves, which means I believe we all exist in six areas of energy domains, meaning emotionally, intellectually, physically, sensually, spiritually, and socially. So those six areas and how in those six areas of all human energy domains, meaning how we build energy, how we produce energy, how we give energy, how, what are my attachments, my social engagement, my safety, where do I feel empowered, valued, what skills do I have in all six areas? And that means in all six areas I have to be able to replenish myself and find balance so that we can give those things to our clients that we have to ourselves. And the way I discovered this, Keith, is about 30 years ago, which means I'd only been in the field for like 10 years, 10 or 12 years. I was truly suffering. I was sick all the time. I had pneumonia, I was literally losing my hair. I was miserably married, miserably parenting, I was a wreck. And of course I never told anybody, because you don't do that in our field. And it was the exact same time I started collecting this qualitative data, and so when I started hearing this from clients I began to realize I could not give them those ingredients. That I couldn't do what it took. I didn't have what it would take. And that's when I started realizing in order to give safety value, power skills, I had to be fit socially, emotionally, spiritually. I had to be in a fit state. I had to be healthy.
Dr. Keith Sutton, Psy.D: (38:22)
Like kind of heal myself.To be able to do that work, Bring it into the work that you're doing with your clients.
Mary Jo Barrett, MSW:(38:29)
Yep. So that's the, you know, that's the concept that in terms of our conversations that to me the essential concepts are this constant rhythm. Of working with our clients. So constant, where are you at? How are you feeling? What do you need at this moment in time? What do you need over time? Creating that context then challenging by teaching new skills, by enactments, challenging what's going on. Then consolidating that shift, that change, that discomfort, that dysregulation to reregulate. So this constant, constant cycle with being able in those different phases to make sure that the five essential ingredients are present. Which means I have to be in really good shape.
Dr. Keith Sutton, Psy.D: (39:40)
Yeah. It's so important because, you know, we are the tool of therapy and need to make sure that we're taking care of ourselves and being able to be there so that we can give to our clients. So important.
Mary Jo Barrett, MSW: (39:54)
So that's one piece. I think the other part, which is just a whole other, and I just got done literally writing with one of the great editors, Lauren of the Networker, an article about when you've cut off from your family and then as life progresses you wanna reconnect. I don't know if you watched the Shrink Next Door.
Dr. Keith Sutton, Psy.D: (40:22)
Oh no. I don't know that one.
Mary Jo Barrett, MSW: (40:25)
What? Are you kidding me?
Dr. Keith Sutton, Psy.D: (40:27)
Yeah, No. I haven’t heard of it.
Mary Jo Barrett, MSW: (40:28)
That's impossible. You might wanna cut that out because it makes you look like such, you're out of the podcast, ,
Dr. Keith Sutton, Psy.D:(40:34)
I'm out of the loop.
Mary Jo Barrett, MSW: (40:36)
But the Shrink next door is, was, a great podcast. And for you, you're a podcaster, so, listen to it before you see the TV show. But it's a real crime. Meaning it was a crime but not a murder, but it was about a shrink who literally orchestrated his client. True. Total true story. Real names. Because it was a New York Times, I think New York Times journalist, to cut off from his family, everything. And then, I mean, and then it was very abusive. What he did, mostly financially. But the point is 27 years later, the guy who's played by Will Ferrell but is a real person, reconnected with his sister. So the reason I bring that up is that's a whole other leg of family therapy that I'm really stepping myself in deep now. I started it in 1994 called the Family Dialogue Project, and now it's becoming really more people. People are saying, I don't wanna be cut off. Maybe I don't want a relationship with the person that abused me or with my QAnon parents, but I don't want to be cut off. So how as a clinician do we help them navigate a safe and healthy relationship? And, again, so many therapists say, who aren't systemic thinkers, you should be cut off. These are terrible evil people and family, family dynamics as you well know. A little more complicated. A little more nuanced.
Dr. Keith Sutton, Psy.D:(42:33)
Well, I think this is another good point because I, again, I think a lot of people even when they think of family therapy, they don't necessarily think of family therapy with adult children and their family members. They think of children, teens and then once the kids 18 family therapy is no longer a thing. But definitely, you know, doing that work and reconnecting, I would be interested in your thoughts on this because you know that oftentimes sometimes with the clients that I work with, it's sometimes thinking about what, you know, oftentimes how the well is dry. They can't get much from that parent. And, you know, oftentimes the parent may still be acting in ways that are feeling abusive or hurtful or dismissive or so on and, so sometimes kind of helping my clients look at how do they get part of what they might need. Also knowing that their parent may have some limitations.How do you think about that with the adults that you're working with wanting to have that connection, but at the same time their parent maybe not be safe still or being sick still, or struggling or not.
Mary Jo Barrett, MSW:(43:38)
I think in the family dialogue process, again, it's a very clear process. So in phase one, which is creating a context. If the person calls me, if they're in, I investigate basically. Are you in therapy? What stage of therapy? Can I talk to your therapist? What's blah blah blah, blah, blah. What are your goals? I want my children to meet my parents. Or I want my children to meet my sibling. My, their cousins, or I don't want the first time I see my brother to be at my parents' funeral or whatever. I mean, I wanna have 20 minutes of Christmas. I mean, who knows? There usually is some concrete goal. And so my feeling is that you really create the context and really see if this is possible. So for example, Keith, if somebody says, I want my father to admit he sexually abused me. Then I say, you gotta do a little more work with your therapist. And I'll talk to the therapist, if they say I want my kids to meet my parents. That's a very attainable goal. So the family dialogue for adults is, let's look at what their goal is and their motivation. So the purpose of the family dialogue is for them, again, that goes back to feeling empowered. To feel in control of some of the interactions. And to feel, you know, valued. And so it's not the purpose of healing their wounds. Except in a different way. Come back differently. So like what I was just talking to this last client was, it's not to come back to have the parents say, yes, I sexually abused you. It's to come back and say, I don't really care if you say you did or not. I know the truth. Yeah. I don't need your validation. I just need to know do you have any, do you wanna see me once a year? And if you do, here's the rules. And I've had some really concrete, one of my favorites that always pops into my head is there was a mother who used to constantly send the child, I don't know what they are because I'm Jewish, but these prayer cards that would talk about forgiveness, you must forgive your father. What you believe, blah, blah, blah. And the kid basically said, you've got to stop mailing them to me. And if you write me letters, this was years ago. Literally years ago, if you write me letters, I want you to write on the back. There is no prayer card here, and that was an agreement and the mother signed it. And you know, and then when we're done, and if you break the agreement, here's what I'm gonna do. So I wanna come home for Thanksgiving. How long can you not drink? Okay. You have to drink by three, then I'll come and I'll leave. And when you drink, I'll leave. That's okay. Or I won't stay at the house. I'll be in a hotel. I mean really concrete agreements about this is the only way I can be in this family. This is what I need.
Dr. Keith Sutton, Psy.D: (47:20)
I was just thinking too, like I'm working with one client who, you know, was very hypervigilant of course trying to manage everybody in the family, you know, kind of in a codependent nature. And so as she's been working through her trauma, she's been stopping doing that and realizing that that's not something, her responsibility or so on. But then it has also taken her next step was then it was taking a focus on, well, I'm gonna set limits with them or so on. But with the focus on the parents saying yes, apologizing or doing differently or so on rather than I think focusing on oneself rather than the other focus of this is what I need. If they're not following those expectations, I need to remove myself, but of course communicating what I need or what's wrong.
Mary Jo Barrett, MSW: (48:11)
Exactly, and then at least the ball's in their court, and that's not often what cutoffs are about. You know, like a therapist often will encourage, and I'm not just saying it's only therapists, like block them while telling them that they're blocked. Or even saying, this is why I'm doing this, or you know,
Dr. Keith Sutton, Psy.D:(48:31)
Because at least if they tell, this is what I need, this is why I'm doing this, then it gives the parent a chance. And the parent may still just not do anything differently, but at least God forbid, the parent dies or something. The adult feels like, well, I did the part on my side of the street and I did as much as I could do, I have no control of the other side. I gave a chance. Well, so tell me about, gosh, there's so much I wanna hear about, but I want to hear about the gang work. I want to hear about, I know you're writing a new book right now. Wherever you wanna go in.
Mary Jo Barrett, MSW: (49:13)
Well, I think, you know, what's most close to my heart right now is working with the families of marginalized, impoverished, and then choosing to affiliate with gang families. And then violence then in their communities. And I think part of that, I mean, it really, I think like so many of us, it really started literally, my involvement three weeks after this ‘16 election. I really, you know, as a child of Vietnam and all that, I really went downhill. I'm not sure I've come up the hill yet, but, and I very magically found, was called by someone who was starting a program for gang members and their families, and said, I know we need more of a trauma lens. And would you be willing, and I mean the universal gift part is they called my cell and I never answered my cell to an unknown. And literally I think it was four days after the election and I answered the phone. So ever since then, they said, would you be willing to teach us, talk to us, look at the program. And when I met the visionary who's a ex gang member, I really recognized this is what I wanted to do with my life is to bring trauma informed, but systemically. So looking at systemic racism, interpersonal violence, historical trauma post-traumatic slavery, integrate all and family. All of that into this process, and the process I didn't think of, although, again, years and years and years ago when I first started working with incest perpetrators and people would say to me, oh my God, how can you work with them? And they'd say they should all be in jail. And I said, well, really quite the contrary. And this is a little obnoxious, but what I would say is no, they really need to be at offender camp. And they shouldn't be in jail. It's a poor use of our money. We should have a place out in wilderness. And that was again, even before all these wilderness programs were rich adolescence. Yeah. That, it is that concept of being in nature and building community. And so this man whose name is Rob Fry, had that experience himself. He's in his fifties now, but as a young adolescent had been taken out of the south side of Chicago and he brought this concept back, but had no idea how to really organize it.And so that's what we do. So we take gang affiliated people and their children and they’re either their women that they have their children with or their girlfriends. And we go out into nature for three days, four days, five days. And run an entire program that is based on the collaborative change model. I mean, completely. So it is involving all sorts of regulation, neuroscience, where we eat healthy, which doesn't happen in the food desert of the south side. We exercise, we teach them to meditate. We have trauma groups, we have psychoeducation groups, we run peace circles and do art, creative arts where they make rap and songs and word spoken word. So they're these days of regulation. And then of course, we observe them dysregulated all throughout Even the first time going out and seeing a squirrel freaks people out. They've never been in nature, a lot of these family members.
Dr. Keith Sutton, Psy.D: (53:57)
What's this program called?
Mary Jo Barrett, MSW: (53:58)
It's called Pride Rock.
Dr. Keith Sutton, Psy.D: (54:00)
Pride Rock, that's great. That sounds incredible.
Mary Jo Barrett, MSW:(54:06)
So it's, so here I am, this old white Jewish woman going out into the wilderness, with gang affiliated people, and probably some of the most rewarding work I've ever done. And the work is no different except perhaps more rewarding than working with, you know, upper middle class white folks. Which in fact, I think a lot of the models out there have been designed for individual private practices.
Dr. Keith Sutton, Psy.D: (55:18)
Now particularly too with these folks that are involved with gangs. What is that like for them or for the clients that you've worked with that have gone through this process understanding trauma more? Because, you know, I know I don't know a lot about, you know, gangs in particular. I know very little, but you know, I know that it's so integrated in a part of life and oftentimes hard to extricate and there's like you're saying about issues around race and around poverty and so on. What does that look like for folks when they come back from a program like this?
Mary Jo Barrett, MSW (55:20)
Well, so one of the concepts is that we go out for three days, we come back, we go out again. It follows the rhythm of the model. And when they're back, we've really created a system in the city where there's clubhouses, there's mentors, we call them life coaches. So they have a lot of contact with and build community. I mean, that's what people get from gangs. They get affiliation, they get family, they feel empowered, they feel valued. All four things about trauma. And so we're trying to create a community and cause it's fellow, excuse me, gang members. They're having the community with the same people and they're just making different choices. Now, this is over time, I mean, we've been doing it for, you know, four years and we have many, a huge amount of the original men and families that went out with us. We're constantly bringing in new people and, you know, we've had no one, knock on wood, shot. Have gun violations. You know, they just have, have experienced regulation, and get with our support. I mean, so it's a constant, a lot of connection and contact. The other thing that we're doing is trying to train other partners. You know, so one of the big things with gangs is jobs. Get these people jobs. Then, but these men, one, make more money without jobs, but two on top of it. Then they're treated in ways that are very triggering to their trauma when they go to work,
Dr. Keith Sutton, Psy.D: (57:26)
When they do get a job.
Mary Jo Barrett, MSW (57:28)
Yeah. So even these programs that get them jobs, you know, they fire them within days because they show up on time versus set up a system of how do I come get you? How do I, you know, and then they might say, well, we're not in the business of babysitting. We're, well, how is somebody who's had generations of never having seen how to get a job? Where does someone learn how to be responsible and go to work? And if you really want to be, look at post-traumatic slavery that a person with that was a slave never had agency. So what happens is, what we're trying to do with partnerships is say, in order to make your non-for-profit successful, you have to be trauma informed in a certain way.
Dr. Keith Sutton, Psy.D: (58:23)
Yeah. Well, and I think too, I imagine that also just any kind of hierarchy that has been experienced has often been oppressive. The school systems, the police, and so on. So then going into a job and having a boss or a manager and so on is going to be, I imagine, very triggering if your experiences have been oppression and discrimination and like you're saying of not having power.
Mary Jo Barrett, MSW: (58:57)
Absolutely, and so it goes back to hierarchy and attachment. So that's, yeah. So that's the piece that we have to look at. And one of the things that is my goal fantasy, is that we take cops on passages. That's what we call what will fill out. Because they're traumatized.
Dr. Keith Sutton, Psy.D:(59:25)
It'd be so interesting. I actually, one of the folks that I interviewed was Joel Faye, who's a local psychologist here who was a police officer and was a police officer and psychologist, and they actually have what's called the West Coast Trauma Retreat. Where first responders, police officers, fire, and so on, go for intensive trauma treatment. That'd be so interesting to kind of hear. Oh, that would be great. Maybe you can connect. So before we run outta time, I wanna hear about your, the book you're working on.
Mary Jo Barrett, MSW: (59:59)
Well the, you know, as you know, I think that part of it, which is a whole other piece about when therapists grow old, right? Is the concept of legacy, I suppose. And I'll, I don't think I'll ever retire but I really, there's this void in the trauma world of teaching and talking about how to do family therapy and the role of family therapy. I think I always call it the missing piece. Yeah. I think it's literally the missing element of really successful trauma treatment.
Dr. Keith Sutton, Psy.D: (01:00:45)
Well, especially too, there's all these evidence-based treatments, you know, and we're finally getting some family therapy models for treating depression. There's lots of models for treating, you know, behavioral issues or, you know, substance abuse or so on. But some of these issues like more internalizing, you know, trauma and anxiety and so on, there's not as many models, so everybody deters to CBT or trauma focused CBT or so on.
Mary Jo Barrett, MSW: (01:01:09)
Right, and so the book is really family therapy. I, you know, I don't have the title yet, it's being written. But you know, systemic treatment of trauma, of complex trauma and how, you know, I, I don't know how I'm gonna put this in, but I do think therapy and particularly trauma therapy has been colonized. And even though I'm a white woman writing, I hope to look at it as saying, is that a real systemic model? Is considering all the social political variables as well. And how to bring that into treatment and how to bring that into family treatment. So, to me, true systemic is how so look at the family and the social political environment. So that's what the book is, is how to really look at complex trauma systemically. So that's, that's, you know, at least I, I hope I have that book left in me.
Dr. Keith Sutton, Psy.D: (01:02:33)
Yes, yes. Well, it sounds like you're doing so much wonderful work and you've really kind of been on this journey, you know, throughout, and all the way back to, like you're saying, kind of the beginning of the child abuse laws and kind of through this process and really kind of figuring it out and coming up with your own kind of blueprint and model and integrating it. It sounds like so much with the, you know, the, the neurological IFS, the polyvagal. And just to kind of circle back to the blueprint. You've talked about phase one and phase two. Is that, are there more phases?
Mary Jo Barrett, MSW: (01:03:15)
The phase, the next phase you just did as I was sitting here thinking, which is consolidation.
So just how you took the podcast. So like my husband says, I do everything in three phases and it's all cyclical. It's the same thing. You created the context by saying how you've known me, and even that I knew your mom. And so you created the context, asked me some questions, say to where we start, then we moved into challenging patterns and sort of saying, okay, so where are you at now? What's going on? What are the challenges? What are you doing? And then you just consolidate it. So, and that happens in seconds and in minutes. And for us, it just happened in 50 minutes. And that, so those are the three phases, and then consolidation is then creating the context. So there’s the three phases, but it's a cycle. So when you consolidate, then you're also creating a context for, look into more about family. You know, your old podcast is creating context.
Dr. Keith Sutton, Psy.D: (01:04:32)
Definitely. So, and then you, and it kind of keeps evolving from there. That sounds wonderful. Good. Well, thank you so much for taking the time. You know, I'm just, I love what you're doing and I love the social justice aspect that you're doing and really kind of expanding into these larger systems and you know, the work that you're doing with the gangs and, you know, just kind of also integrating a lot of these important pieces, the colonization of therapy and systemic racism and oppression and post-slavery and all these kind of pieces into this larger systemic thinking and your model. I'm really looking forward to the book. It sounds great.
Mary Jo Barrett, MSW: (01:05:18)
So the one thing I would wanna say is, you know, in this time, Keith, that we're all living in Which is pretty difficult and struggling and unknown. I would really like to tell your listeners that, I'm not saying go volunteer to make yourself feel good. I'm saying that because so many of us feel powerless and out of control and disconnected and devalued. That and feeling really powerless. Like, what can I do? I really want to share that, you know, a couple hours a week of really feeling like you're making a significant social political or, and psychological and emotional and spiritual difference in one or two lives. Where people who can't afford the great therapy that all your listeners are doing. Yet deserve all that great work. That I just really wanna encourage people that it's, you know, we all, we have to be a village right now. In this world
Dr. Keith Sutton, Psy.D: (01:06:40)
And giving of, even just like you're saying, those few hours or so on, can have a larger impact rather than some people just get so overwhelmed with there's so much and I can't change it.
Mary Jo Barrett, MSW: (01:06:50)
That’s right, I got overwhelmed
Dr. Keith Sutton, Psy.D: (01:06:52)
Just doing small acts that might build and, and keep that as part of their work.
Mary Jo Barrett, MSW: (01:06:58)
Right. I truly believe therapists have a sacred gift. I do. It's a gift. It's an art and it's a gift, and it's very sacred, and the world needs it right now.
Dr. Keith Sutton, Psy.D: (01:07:09)
Yeah. Well, thank you for giving us this gift of, you know, the work that you're doing, and thank you. It's great to hear. And I'm, you know, I'm sure you know, listeners are gonna be really, you know, inspired by this work. And thank you so much for taking the time. I really appreciate it.
Mary Jo Barrett, MSW: (01:07:27)
Thank you.
Dr. Keith Sutton, Psy.D: (01:07:28)
Okay. Take care. Bye bye.
Dr. Keith Sutton, Psy.D: (01:07:30)
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Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advancements in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy. Today I'll be speaking with Mary Jo Barrett, who's a social worker and is the author of Incest, A multiple systems perspective and Treating Complex Trauma, a relational blueprint for collaboration and change. She's also the executive director and co-founder of the Center for Contextual Change, and in the past has been on the faculties of the University of Chicago School of Social Service Administration, the Chicago Center for Family Health, and the Family Institute of Northwestern University. Mary Jo was the director of the Midwest Family Resource and has been working in the field of family violence since 1974. She focuses on the teaching of the collaborative stage model, systemic and feminist treatment of women, adult survivors of sexual abuse and trauma eating disorders, couple therapy, post-traumatic stress disorder, and compassion fatigue. Let's listen to the interview. Hi Mary Jo. Thank you for joining us today.
Mary Jo Barrett, MSW: (01:31)
Hello, how are you?
Dr. Keith Sutton, Psy.D: (01:33)
Good. So I know of your work. I think, gosh, we had run into each other at the AFTA American Family Therapy Academy conference, and I know Jim Keim, a colleague of mine, has spoken highly of your work. And we ended up chatting and, you know, actually coordinating for you to go out. My, my mother was living and doing work in Zanzibar and you went out and did some work there and did some training in with folks in mental health and around child abuse and things like that. And so yeah, I reached out because I, I know you're doing some wonderful work and I'd love to hear about, you know, your work and what you've been up to lately. But first let's start off, and I, I'd always love to find out about kind of folks' careers and kind of how they got into doing what they're doing and their evolution of thinking.
Mary Jo Barrett, MSW: (02:24)
Yep. So that's a really good question for me because mine's so straightforward I think. Yeah. So Keith, I've been in the field for probably well over 40 years, and what's interesting is just in terms of thinking, I was an undergraduate and it was at Northwestern and it was before family therapy and I majored in community psych. Which is not even a big thing that much now probably, people can't even major in it, I don't know. And so I majored in community psych and my emphasis, kind of a thesis kind of thing but not really, was on child abuse. So I've done nothing else but interpersonal violence since I was 21. And I would say it was by chance, that piece, of course nothing's totally by chance as we know. But the other piece that I think was really influential is that I, right out of social work, right out of social work, social work graduate school. So that was 1978 and the child abuse law only came into being in 1976 around. I was the first, I worked at the agency that was the first in-home counseling agency for the Department of Children Family Service on a child abuse and neglect cases. So basically in the state of Illinois, I was the first in-home counselor for abuse and neglect. And, at some point, I mean, I won't tell you the whole story but if you ever wanna listen to my story of my first very first client. But my very first client was a Chicago cop who was abusive to everybody in his family in some way. And so, the piece is that I was there sitting in the family, in the home, and kind of having no idea what to do. You know, I mean, there was no training. There was no teaching. And as time went by, it became really clear to me that I couldn't just work with the child who was still living in the home. I couldn't just work with the parents. I had to do more in terms of the family. So I went back for postgraduate in family therapy because it's the only thing that made sense to me. And what was also really interesting is that when I went back, and you're familiar with all the names, I did a lot of training with Carl Whitaker because he's a Midwest guy, I'm a Midwest gal. And I would call in with him talking about these incest cases or child abuse and he, because what a wonderful, lovely person he is would say to me, “Hey, I know schizophrenia and families. And I know systems thinking, but you are” and he literally at one point said to me, which is a good mentor, “You are gonna have to be the one that figures out systemic thinking for violence in a family. That's your generation, you’re next.” And, which just sort of reminds me that in some ways this podcast, I'm speaking to the next generation, like he spoke to me. Which we'll get to later. So that's how I came into it. And I, being a family therapist, one of the ways that I literally taught myself on how to do this was studying family therapy for sure. Also I spent a lot of time asking families. Okay. Just like we all know as family therapists, you're the expert, so teach me. What do you, what help do you need as a family where there's violence, where there's incest, where there's sexual abuse? And to this day, I'm still saying that to families.
Dr. Keith Sutton, Psy.D: (06:56)
Approaching and really learning from their knowledge.
Mary Jo Barrett, MSW: (07:00)
Right. And even to the point of every session, what out of this session worked? What didn't, what do you need? Where are we going? And because of what I learned, I developed a model called the collaborative change model. Which is a meta model. It's not intervention based. It's concept based and it's about how to. There's two major concepts in the model, which is how to collaborate and integrate your therapist. Not as us doing something to them. The hierarchy, the issues, hierarchy and attachment, which are paramount in therapeutic relationships. Those are the same issues in interpersonal violence. Hierarchy and attachment. So the importance is, for us as therapists, not to be doing something to the client. That it's collaborative, which abuse is not. Abuse is not a collaborative endeavor. So what we want in a relationship of hierarchy and attachment is to collaborate. So that's one essence of the collaborative change model. The other sort of guiding factor is timing. I always say to students, I'm teaching, you gotta look at good therapy like good comedy, which is timing is everything. And so this metaconcept is about timing in sessions. When do you do what, how do you recognize what's going on in the room? How do you change direction? When do you, how do you collaborate? It's all about stepping back and having an awareness of what's going on in the system in the room at the moment. So those are old family therapy getting enactments, but the difference is, we have an enactment, or I'm creating a crisis. How do I time that?
Dr. Keith Sutton, Psy.D:(09:12)
To kind of be more successful.
Mary Jo Barrett, MSW: (09:14)
Yeah. So those are the two pieces of the collaborative change model. And they're the two things I learned by asking thousands of clients what works. What therapy have you done in the past that didn't work?
Dr. Keith Sutton, Psy.D: (09:28)
Can you tell me a little more about this timing? Is it kind of like, first you wanna achieve this and then that or so on? Or is it a felt sense? It sounds like you've got a roadmap of where we are and what we need to do next.
Mary Jo Barrett, MSW: (09:44)
The book is called the blueprint for, it's the blueprint for collaboration and change. It's literally a blueprint. And it's based, Keith, on the natural process for change. Meaning not Mary Jo Barrett's natural, but the universes’. Like how seasons go, how the trees go, how day and night goes. It's a rhythm of what I call contraction and expansion. So it's, it's a felt sense and it's a cognitive sense. I mean, it kind of reflects the whole body. And so it's a felt sense in the room what's happening with me as a therapist with the client and perhaps in our interaction. Is this the moment I need to contract? Do we need to, it's basically do we need to lower the nervous system? Do we need to get re-grounded? Do we need to get refocused? Do we need to take time? Then, when a felt sense, but also a cognitive sense by me saying, hey Keith, are you ready to move on? Where are you at? Are you with me? Do I have permission to ask this question? Can we go forward? Then, it's a challenge, which I consider an expansion. So then I push, I do one of the interviews in intervention I might know from IFS or EMDR or whatever. And then I watch. See where it landed, you know, see where it's at. Do I contract? And so there's a rhythm. Now if you have read, and I'm sure all your listeners are completely steeped in neuroscience now, what's interesting is Bruce Perry who's very involved. I mean his you know, complex trauma, he's the king. He talks about the brain needing a rhythm. That the brain needs this rhythm. That's why, you know, music, walking, like eMDR is a rhythmic thing. And I, I heard him say this after, obviously I developed a collaborative change model. But then it made sense to me that this rhythm I'm talking about in session and over time is soothing.
Dr. Keith Sutton, Psy.D: (12:19)
Yeah. Well, it sounds like you're really kind of also providing that co-regulation. Like kind of helping to regulate and ground and contain and hold, and then kind of helping the person then kind of go outside of their comfort zone and creating some change or creating some crisis or enactment or, you know, kind of going into a discomfort and, and potentially even leading to something that might change a paradigm and then kind of holding that.
Mary Jo Barrett, MSW: (12:50)
Exactly. And it could happen 10 times in a session, and it happens over time. So it's both a macro and a micro. I think the one thing that I wanna say is that you're absolutely right. You described it perfectly. Beautiful summary consolidation. I teach this to my clients. That's the goal again. So when the client first comes in I say, so here's the rhythm we're gonna go for. So when I stop, this is why I'm stopping. When I pause and I ask you questions, I teach them intro to polyvagal, and then I talk about how that's gonna happen in a session, how it's also gonna happen outside. That's why I like having family members, because I teach them together how to co-regulate these concepts. Like I, I'm very, very, very involved in working with people who are gang affiliated on the South side of Chicago. I'm sort of going back to my roots. I started on the south side of Chicago in violent interpersonal violence. But if you came, I mean, that whole program we could talk about when you wanna know about what I'm currently doing. But, if you came to any of our groups, or what we do, these retreats, you'd think they all went to UFC in neuroscience. They talk brain all the time. They talk about, they call different parts of their brains different things, but they talk about trauma, mind state. They talk about this rhythm because as soon as I've created relationships with them or any of the other staff, then the next step is this part of really explaining to them the process of change.
Dr. Keith Sutton, Psy.D: (14:53)
Yeah. Well, and it's so important when working with someone, I mean, anyone in general, but especially somebody who has experienced complex trauma and really being very transparent and collaborative. You know, sometimes I tell my clients, hey, you're the captain of the ship. Kind of deciding where we go so that there is a feeling, a sense of control, and feeling kind of safe and being able to speak up and so on and know what's going on here rather than feeling like, you know, the therapist is doing something and feeling fear about what this person is doing. And so, it sounds like you're really kind of communicating that every step along the way of letting them into what you know and what you're thinking and so on. And really kind of walking together.
Mary Jo Barrett, MSW:(15:37)
Right. The four major themes or the four major impacts of interpersonal violence, which has come to be called complex trauma, although I still think the majority of what we're talking about that comes into our office is usually violations or neglect. And, is that when that happens over the lifespan it leaves a person powerless, out of control, devalued, and disconnected. Our therapy, each and every moment as much as we can, and each and every
session should be empowering. Having people feel in control, having people feel valued, and having people feel connected. So how you do that, there's lots of variations and it can be your own personality and your own model. Yet those are, can you look back at any second in a session, I should be able to look back and say, oh, Keith, that was real. You just gave, that was great. They were empowered, you valued them. It's something that has to be overarching. Is helping establish power, control, connection, value.
Dr. Keith Sutton, Psy.D: (16:58)
Definitely. Now you're, you know, I think for many people when they would think about working with a child who had experienced incest or working with violence in the home or so on, oftentimes people would think, oh no, you can't do family or couples therapy with that type of situation. You can only do individual work. Tell me about your thinking around this.
Mary Jo Barrett, MSW: (17:22)
Well, okay. So my thinking is, again, it goes back to timing. There is that when you bring people in the room together and how you bring people in the room together varies. You know, so like, domestic violence might be different than incest. I get it's also about living together. I mean, even if people are still living together, what's the sense of risk? So, in what I call the first phase, which is creating a context, I mean they're all named. Like creating a context for change, my initial say is assessment, safety assessment. And so I don't necessarily bring everybody together in the room If I assess it's not safe. However, I will try to coordinate getting everybody in the process. And knowing that there's timing. So if there's domestic violence but they're still living together, then I will say we will do couples. But we're not gonna do couples until I get to know both of you and can assess the assessment. So I do couples for domestic violence, it's again when. If it's incest and there's divorce but the child still sees the father or wants to see them, usually they won't see them. Then it's a matter of getting the father in therapy into an offender program to work on his denial. But we're all knowing that perhaps in phase two, which I call challenging patterns and expanding realities, that it will happen. So the goal is we will eventually do or be in interaction with each other. Because very few families are completely cut off, right? And so that's one thing. The other piece is that when a survivor calls me, one of my first questions, are you married? Do you live with someone? Do you have children? And if they say yes, again, I introduce the concept. I don't know when, but the family will be together. Now, if they're married, I will probably ask immediately to see the partner. If they're living together. So it, it's again, it's about timing. There will be family sessions and it's a collaborative effort to when that will happen. And most of the time, the clients want family therapy. They're not reactive when I say it. They know they're in relationships and they know their relationships are suffering. That it's, it's really societal, and it's our culture. I think as therapists that we've looked at adult survivors with individual models.
But they don't, they don't live alone.
Dr. Keith Sutton, Psy.D: (20:53)
So it sounds like, as you're saying, listening to the clients and finding out what they need, we were chatting about this before we got started, that they're, the clients are telling you that they want To do this work or feeling, or you were even mentioning a client earlier today was saying, I feel like I need to address this with my parents to really heal.
Mary Jo Barrett, MSW: (21:15)
Yeah. And that's four or five years into the therapy, not just with me, with other people. Yeah. But they've, you know, four or five years they're saying, okay, now it's, I think it's time for my next stage. So to me, when I say timing over timing, I mean, you know, when someone says to me, I'm ready, I need to have a conversation with my parents. To me, they're in stage two now. They've been in stage two for other things in their life, they're even, they probably have consolidated things. Like right now, this particular client's doing great. Has life, sees people, makes money, is totally functioning. So because they've consolidated part of their healing now they're ready to do this next challenge. And, I get a lot of those referrals. So I'm not saying that individual is a terrible thing. I think people do a lot of healing. I'm just saying it's not enough.
Dr. Keith Sutton, Psy.D: (22:20)
So I know you have particular thoughts about the relationship between the therapists and the client and some elements that lead to success in therapy and that are essential. Could you talk a little bit about those aspects?
Mary Jo Barrett, MSW:(22:34)
Okay. Yeah. So what we did, Keith, is, and, and it wasn't just me. It's been all over wherever I've taught, or anyone that's been trained in the CCM, the collaborative change model, is that we've asked people what was the important ingredients. Like what happened in this session that was really helpful. If we're talking at the end of the session, what are you feeling right now? And we would ask that periodically, like, how is therapy going? Are we meeting your goals? Let's look at the goals you first brought up when you first came in, or do you feel like our sessions are meeting it? So it's this constant, and if you, you know, think about the collaborative change model, It's a constant consolidation. So we consolidate before we create a context, so checking in, where are you at? And what we discerned were these five, that there were five essential ingredients that had to happen throughout therapy and in every session and throughout the session. So those five things, and then I'm gonna talk a little bit about the therapist on self in relation, is that the first thing the client said which we all know right? Was the relationship with the clinician. I mean, we all know that there's been tons of research, tons of articles. But what we know, what the clients told us in their own words is that it was the relationship. And the relationship was more than just I liked my therapist, or I thought my therapist was smart. It was they really had a sense that their clinician, their therapist, was curious, compassionate, and empathetic. And that they were good human beings. So to me it was connecting them that they really thought the values of the clinician were good, and that the clinician also had a vision of the future. Whether that meant a vision of what we're gonna do here in therapy, this is how this works. But it was also a vision of how the client was going to be. Right? And the other thing they said, which is, was necessary, and this is what they said, which is the argument for systems, is that they found the sessions with their family members in the room some of the most essential. Whether it was an adult survivor who said that session with my mother, or the adult survivor I saw just yesterday who had a session with her brother who had sexually abused her. She only had three sessions, but she said those were the, some of the most essential. Working on marriages, working on parenting. You know, like the couple I saw earlier came in with a huge fight, and it was obviously, as you and I know, around how they can parent better together. So, and this was somebody who had only had individual therapy for their dysregulation. So what? So that's the first piece, is the work, the attachment with the therapist, but also their relationships in their lives where there was more empathy and compassion and curiosity created. Do you wanna ask about that?
Dr. Keith Sutton, Psy.D:(26:32)
Well, I was gonna say, you know, you were mentioning earlier about the Scott Miller work and the feedback informed treatment. And the way I think about it, oftentimes it's about attunement. Also about kind of attuning to our clients asking for feedback directly and noticing, you know, what we're getting kind of non-verbally and so on throughout the sessions to maintain that connection. And kind of moving together, rather than getting ahead of our clients or pulling them along or pushing or so on.
Mary Jo Barrett, MSW: (26:59)
Yeah. And if I don't address those exact words in a minute, remind me about it. The second thing that the clients told us was about safety and empowerment. And again, we all know this about trauma, but what does that mean in their words? Is that they had to feel safe in the relationship? And the relationship with the clinician was they had to have clear boundaries. It had to be predictable. They had to understand the process. Like, why is this, why are we doing this now? How does therapy work? And they had to recognize that the clinician was gonna help them feel safe in their relationships with their family, not just in the room again. Like yesterday I was, or the other day I was seeing a client who was, the kid was saying to me I don't feel safe. And what they were talking about is how their parents were handling covid. And that word that the importance in the session became, how can we help you feel safe at home? So that whole thing, and the empowerment comes by again, asking the clients, right? Getting informed of what the clients need. That's empowerment. The third thing the client said is they had to feel valued. They had to, they had the, that again it's a conscious effort on the therapist. Is the client feeling valued with how I'm treating them? Am I saying things that are, again as we as family therapists know, are strength based? Am I really utilizing their resources and their strengths in how I'm designing the therapy? Am I commenting on their strengths? Am I, can I look at myself and say, how do I value this crime? You know, I think, I don't know, I think I told you about my first client, the police officer. Maybe I didn't. But when I interviewed the mom 40 years later the father who had been the victim, I mean the father who had been the abuser had died. And I interviewed them 40 years after I had first seen them. They were my first client. It was pretty remarkable. And the mom, when I said to her, do you remember that session when I made the home visit? And everybody was throwing glass at each other when I walked in? And she said, yes. And I said that was huge in my career. What, how do you remember it? And she said, I remember that session as you were the first person who ever had faith in me. And I was a 24 year old, 25 year old social worker that had no clue what I was doing, had walked in when people were literally throwing glasses at each other. And somehow whatever I did made her feel and that she remembered 40 years.
So that's again, that sense of feeling value.
Dr. Keith Sutton, Psy.D: (30:28)
Well, I think too, that oftentimes, when the client experiences the therapist as seeing the person in them that they want to be, or that they are becoming, or they're kind of the part of them that they really appreciate rather than just their problem. That oftentimes feeling that connection and more of that hope. I think too that this aspect is valued. Jim Keim, my colleague, we discussed family therapy at times and he talked about, you know, how important it is to have empathy and value for your clients. And that he always recommends working with sex offenders, because he says it will really challenge your ability to be empathic and, you know, to really find something that's likable and valuable in your client, even though maybe they engaged in these horrific acts. I don't know if you have any thoughts on that.
Mary Jo Barrett, MSW: (31:21)
Yeah I mean, that's, you know, because I work with a lot of offenders, it is about finding something you value in them. I mean, and sometimes if I can't, then I have to figure out, how do I help them find somebody that can value them. Although when I very consciously say, this is what I'm doing right now, is to look really hard at what I can value about them. And that's where my questions are. I usually find something. But they, but the client said they needed to feel valued. So the fourth thing they said was skills. Literally psychoeducation. So all those things, even though I keep saying, let's not be intervention oriented, let's be more meta oriented, they do need skills. And they said that learning how to meditate, learning good communication, learning self-regulation, and again, going to the systems piece is that they said if everybody was learning the same mindfulness, it was helpful then if I learned how to regulate and went home to a dysregulated house. So again, I have all sorts of handouts where I try to teach people about the polyvagal, about, you know, they’re very understandable worksheets. And it's important for everybody in the family to know. So, the last thing they said was hope. And that was that the clinician really did believe one; that what they're doing was gonna be helpful and could work. And two; that they had hope and that they instilled hope in the process and in the context. And one of the things that I go for at the end of the session is, how are you feeling right now? And I'm looking for those words of, this was helpful. This was helpful. This made sense to me. I'm looking for words of regulations. You know, social engagement. I'm, and what I'm saying about I believe these ingredients are, is that we need to be conscious of them. They should be a checklist. I should be able to walk into any session, any clinician, and take that snapshot of that moment and see in that relationship at least one, two, or three in that moment of these happen in one way or another.
Dr. Keith Sutton, Psy.D:(34:37)
Yeah. Because otherwise all the processes or techniques or stages or so on are, you know, not gonna do much if you don't have that relationship. And then you end up kind of having the therapist pulling along the client or pushing them along or so on and getting frustrated. And getting into kind of seeing them as quote unquote “resistant.”
Mary Jo Barrett, MSW: (34:58)
Right. Exactly. Exactly. Now, which then goes on to the next piece is that all of us need these five essential ingredients. In our lives to stay what I call ethically attuned. I think it's an ethical imperative for therapists to be fit. And, and when I say fit that, it means how are these five things happening in my life? Do I feel valued in my own life? Do I practice my skills or no skills? Do I feel, what is my, who am I attached with? What's my social engagement? Do I have friends? How am I, what's my spiritual essence? And so, to me, in order to do these five ingredients or integrate them into the treatment, we have to be also ethically attuned ourselves, which means I believe we all exist in six areas of energy domains, meaning emotionally, intellectually, physically, sensually, spiritually, and socially. So those six areas and how in those six areas of all human energy domains, meaning how we build energy, how we produce energy, how we give energy, how, what are my attachments, my social engagement, my safety, where do I feel empowered, valued, what skills do I have in all six areas? And that means in all six areas I have to be able to replenish myself and find balance so that we can give those things to our clients that we have to ourselves. And the way I discovered this, Keith, is about 30 years ago, which means I'd only been in the field for like 10 years, 10 or 12 years. I was truly suffering. I was sick all the time. I had pneumonia, I was literally losing my hair. I was miserably married, miserably parenting, I was a wreck. And of course I never told anybody, because you don't do that in our field. And it was the exact same time I started collecting this qualitative data, and so when I started hearing this from clients I began to realize I could not give them those ingredients. That I couldn't do what it took. I didn't have what it would take. And that's when I started realizing in order to give safety value, power skills, I had to be fit socially, emotionally, spiritually. I had to be in a fit state. I had to be healthy.
Dr. Keith Sutton, Psy.D: (38:22)
Like kind of heal myself.To be able to do that work, Bring it into the work that you're doing with your clients.
Mary Jo Barrett, MSW:(38:29)
Yep. So that's the, you know, that's the concept that in terms of our conversations that to me the essential concepts are this constant rhythm. Of working with our clients. So constant, where are you at? How are you feeling? What do you need at this moment in time? What do you need over time? Creating that context then challenging by teaching new skills, by enactments, challenging what's going on. Then consolidating that shift, that change, that discomfort, that dysregulation to reregulate. So this constant, constant cycle with being able in those different phases to make sure that the five essential ingredients are present. Which means I have to be in really good shape.
Dr. Keith Sutton, Psy.D: (39:40)
Yeah. It's so important because, you know, we are the tool of therapy and need to make sure that we're taking care of ourselves and being able to be there so that we can give to our clients. So important.
Mary Jo Barrett, MSW: (39:54)
So that's one piece. I think the other part, which is just a whole other, and I just got done literally writing with one of the great editors, Lauren of the Networker, an article about when you've cut off from your family and then as life progresses you wanna reconnect. I don't know if you watched the Shrink Next Door.
Dr. Keith Sutton, Psy.D: (40:22)
Oh no. I don't know that one.
Mary Jo Barrett, MSW: (40:25)
What? Are you kidding me?
Dr. Keith Sutton, Psy.D: (40:27)
Yeah, No. I haven’t heard of it.
Mary Jo Barrett, MSW: (40:28)
That's impossible. You might wanna cut that out because it makes you look like such, you're out of the podcast, ,
Dr. Keith Sutton, Psy.D:(40:34)
I'm out of the loop.
Mary Jo Barrett, MSW: (40:36)
But the Shrink next door is, was, a great podcast. And for you, you're a podcaster, so, listen to it before you see the TV show. But it's a real crime. Meaning it was a crime but not a murder, but it was about a shrink who literally orchestrated his client. True. Total true story. Real names. Because it was a New York Times, I think New York Times journalist, to cut off from his family, everything. And then, I mean, and then it was very abusive. What he did, mostly financially. But the point is 27 years later, the guy who's played by Will Ferrell but is a real person, reconnected with his sister. So the reason I bring that up is that's a whole other leg of family therapy that I'm really stepping myself in deep now. I started it in 1994 called the Family Dialogue Project, and now it's becoming really more people. People are saying, I don't wanna be cut off. Maybe I don't want a relationship with the person that abused me or with my QAnon parents, but I don't want to be cut off. So how as a clinician do we help them navigate a safe and healthy relationship? And, again, so many therapists say, who aren't systemic thinkers, you should be cut off. These are terrible evil people and family, family dynamics as you well know. A little more complicated. A little more nuanced.
Dr. Keith Sutton, Psy.D:(42:33)
Well, I think this is another good point because I, again, I think a lot of people even when they think of family therapy, they don't necessarily think of family therapy with adult children and their family members. They think of children, teens and then once the kids 18 family therapy is no longer a thing. But definitely, you know, doing that work and reconnecting, I would be interested in your thoughts on this because you know that oftentimes sometimes with the clients that I work with, it's sometimes thinking about what, you know, oftentimes how the well is dry. They can't get much from that parent. And, you know, oftentimes the parent may still be acting in ways that are feeling abusive or hurtful or dismissive or so on and, so sometimes kind of helping my clients look at how do they get part of what they might need. Also knowing that their parent may have some limitations.How do you think about that with the adults that you're working with wanting to have that connection, but at the same time their parent maybe not be safe still or being sick still, or struggling or not.
Mary Jo Barrett, MSW:(43:38)
I think in the family dialogue process, again, it's a very clear process. So in phase one, which is creating a context. If the person calls me, if they're in, I investigate basically. Are you in therapy? What stage of therapy? Can I talk to your therapist? What's blah blah blah, blah, blah. What are your goals? I want my children to meet my parents. Or I want my children to meet my sibling. My, their cousins, or I don't want the first time I see my brother to be at my parents' funeral or whatever. I mean, I wanna have 20 minutes of Christmas. I mean, who knows? There usually is some concrete goal. And so my feeling is that you really create the context and really see if this is possible. So for example, Keith, if somebody says, I want my father to admit he sexually abused me. Then I say, you gotta do a little more work with your therapist. And I'll talk to the therapist, if they say I want my kids to meet my parents. That's a very attainable goal. So the family dialogue for adults is, let's look at what their goal is and their motivation. So the purpose of the family dialogue is for them, again, that goes back to feeling empowered. To feel in control of some of the interactions. And to feel, you know, valued. And so it's not the purpose of healing their wounds. Except in a different way. Come back differently. So like what I was just talking to this last client was, it's not to come back to have the parents say, yes, I sexually abused you. It's to come back and say, I don't really care if you say you did or not. I know the truth. Yeah. I don't need your validation. I just need to know do you have any, do you wanna see me once a year? And if you do, here's the rules. And I've had some really concrete, one of my favorites that always pops into my head is there was a mother who used to constantly send the child, I don't know what they are because I'm Jewish, but these prayer cards that would talk about forgiveness, you must forgive your father. What you believe, blah, blah, blah. And the kid basically said, you've got to stop mailing them to me. And if you write me letters, this was years ago. Literally years ago, if you write me letters, I want you to write on the back. There is no prayer card here, and that was an agreement and the mother signed it. And you know, and then when we're done, and if you break the agreement, here's what I'm gonna do. So I wanna come home for Thanksgiving. How long can you not drink? Okay. You have to drink by three, then I'll come and I'll leave. And when you drink, I'll leave. That's okay. Or I won't stay at the house. I'll be in a hotel. I mean really concrete agreements about this is the only way I can be in this family. This is what I need.
Dr. Keith Sutton, Psy.D: (47:20)
I was just thinking too, like I'm working with one client who, you know, was very hypervigilant of course trying to manage everybody in the family, you know, kind of in a codependent nature. And so as she's been working through her trauma, she's been stopping doing that and realizing that that's not something, her responsibility or so on. But then it has also taken her next step was then it was taking a focus on, well, I'm gonna set limits with them or so on. But with the focus on the parents saying yes, apologizing or doing differently or so on rather than I think focusing on oneself rather than the other focus of this is what I need. If they're not following those expectations, I need to remove myself, but of course communicating what I need or what's wrong.
Mary Jo Barrett, MSW: (48:11)
Exactly, and then at least the ball's in their court, and that's not often what cutoffs are about. You know, like a therapist often will encourage, and I'm not just saying it's only therapists, like block them while telling them that they're blocked. Or even saying, this is why I'm doing this, or you know,
Dr. Keith Sutton, Psy.D:(48:31)
Because at least if they tell, this is what I need, this is why I'm doing this, then it gives the parent a chance. And the parent may still just not do anything differently, but at least God forbid, the parent dies or something. The adult feels like, well, I did the part on my side of the street and I did as much as I could do, I have no control of the other side. I gave a chance. Well, so tell me about, gosh, there's so much I wanna hear about, but I want to hear about the gang work. I want to hear about, I know you're writing a new book right now. Wherever you wanna go in.
Mary Jo Barrett, MSW: (49:13)
Well, I think, you know, what's most close to my heart right now is working with the families of marginalized, impoverished, and then choosing to affiliate with gang families. And then violence then in their communities. And I think part of that, I mean, it really, I think like so many of us, it really started literally, my involvement three weeks after this ‘16 election. I really, you know, as a child of Vietnam and all that, I really went downhill. I'm not sure I've come up the hill yet, but, and I very magically found, was called by someone who was starting a program for gang members and their families, and said, I know we need more of a trauma lens. And would you be willing, and I mean the universal gift part is they called my cell and I never answered my cell to an unknown. And literally I think it was four days after the election and I answered the phone. So ever since then, they said, would you be willing to teach us, talk to us, look at the program. And when I met the visionary who's a ex gang member, I really recognized this is what I wanted to do with my life is to bring trauma informed, but systemically. So looking at systemic racism, interpersonal violence, historical trauma post-traumatic slavery, integrate all and family. All of that into this process, and the process I didn't think of, although, again, years and years and years ago when I first started working with incest perpetrators and people would say to me, oh my God, how can you work with them? And they'd say they should all be in jail. And I said, well, really quite the contrary. And this is a little obnoxious, but what I would say is no, they really need to be at offender camp. And they shouldn't be in jail. It's a poor use of our money. We should have a place out in wilderness. And that was again, even before all these wilderness programs were rich adolescence. Yeah. That, it is that concept of being in nature and building community. And so this man whose name is Rob Fry, had that experience himself. He's in his fifties now, but as a young adolescent had been taken out of the south side of Chicago and he brought this concept back, but had no idea how to really organize it.And so that's what we do. So we take gang affiliated people and their children and they’re either their women that they have their children with or their girlfriends. And we go out into nature for three days, four days, five days. And run an entire program that is based on the collaborative change model. I mean, completely. So it is involving all sorts of regulation, neuroscience, where we eat healthy, which doesn't happen in the food desert of the south side. We exercise, we teach them to meditate. We have trauma groups, we have psychoeducation groups, we run peace circles and do art, creative arts where they make rap and songs and word spoken word. So they're these days of regulation. And then of course, we observe them dysregulated all throughout Even the first time going out and seeing a squirrel freaks people out. They've never been in nature, a lot of these family members.
Dr. Keith Sutton, Psy.D: (53:57)
What's this program called?
Mary Jo Barrett, MSW: (53:58)
It's called Pride Rock.
Dr. Keith Sutton, Psy.D: (54:00)
Pride Rock, that's great. That sounds incredible.
Mary Jo Barrett, MSW:(54:06)
So it's, so here I am, this old white Jewish woman going out into the wilderness, with gang affiliated people, and probably some of the most rewarding work I've ever done. And the work is no different except perhaps more rewarding than working with, you know, upper middle class white folks. Which in fact, I think a lot of the models out there have been designed for individual private practices.
Dr. Keith Sutton, Psy.D: (55:18)
Now particularly too with these folks that are involved with gangs. What is that like for them or for the clients that you've worked with that have gone through this process understanding trauma more? Because, you know, I know I don't know a lot about, you know, gangs in particular. I know very little, but you know, I know that it's so integrated in a part of life and oftentimes hard to extricate and there's like you're saying about issues around race and around poverty and so on. What does that look like for folks when they come back from a program like this?
Mary Jo Barrett, MSW (55:20)
Well, so one of the concepts is that we go out for three days, we come back, we go out again. It follows the rhythm of the model. And when they're back, we've really created a system in the city where there's clubhouses, there's mentors, we call them life coaches. So they have a lot of contact with and build community. I mean, that's what people get from gangs. They get affiliation, they get family, they feel empowered, they feel valued. All four things about trauma. And so we're trying to create a community and cause it's fellow, excuse me, gang members. They're having the community with the same people and they're just making different choices. Now, this is over time, I mean, we've been doing it for, you know, four years and we have many, a huge amount of the original men and families that went out with us. We're constantly bringing in new people and, you know, we've had no one, knock on wood, shot. Have gun violations. You know, they just have, have experienced regulation, and get with our support. I mean, so it's a constant, a lot of connection and contact. The other thing that we're doing is trying to train other partners. You know, so one of the big things with gangs is jobs. Get these people jobs. Then, but these men, one, make more money without jobs, but two on top of it. Then they're treated in ways that are very triggering to their trauma when they go to work,
Dr. Keith Sutton, Psy.D: (57:26)
When they do get a job.
Mary Jo Barrett, MSW (57:28)
Yeah. So even these programs that get them jobs, you know, they fire them within days because they show up on time versus set up a system of how do I come get you? How do I, you know, and then they might say, well, we're not in the business of babysitting. We're, well, how is somebody who's had generations of never having seen how to get a job? Where does someone learn how to be responsible and go to work? And if you really want to be, look at post-traumatic slavery that a person with that was a slave never had agency. So what happens is, what we're trying to do with partnerships is say, in order to make your non-for-profit successful, you have to be trauma informed in a certain way.
Dr. Keith Sutton, Psy.D: (58:23)
Yeah. Well, and I think too, I imagine that also just any kind of hierarchy that has been experienced has often been oppressive. The school systems, the police, and so on. So then going into a job and having a boss or a manager and so on is going to be, I imagine, very triggering if your experiences have been oppression and discrimination and like you're saying of not having power.
Mary Jo Barrett, MSW: (58:57)
Absolutely, and so it goes back to hierarchy and attachment. So that's, yeah. So that's the piece that we have to look at. And one of the things that is my goal fantasy, is that we take cops on passages. That's what we call what will fill out. Because they're traumatized.
Dr. Keith Sutton, Psy.D:(59:25)
It'd be so interesting. I actually, one of the folks that I interviewed was Joel Faye, who's a local psychologist here who was a police officer and was a police officer and psychologist, and they actually have what's called the West Coast Trauma Retreat. Where first responders, police officers, fire, and so on, go for intensive trauma treatment. That'd be so interesting to kind of hear. Oh, that would be great. Maybe you can connect. So before we run outta time, I wanna hear about your, the book you're working on.
Mary Jo Barrett, MSW: (59:59)
Well the, you know, as you know, I think that part of it, which is a whole other piece about when therapists grow old, right? Is the concept of legacy, I suppose. And I'll, I don't think I'll ever retire but I really, there's this void in the trauma world of teaching and talking about how to do family therapy and the role of family therapy. I think I always call it the missing piece. Yeah. I think it's literally the missing element of really successful trauma treatment.
Dr. Keith Sutton, Psy.D: (01:00:45)
Well, especially too, there's all these evidence-based treatments, you know, and we're finally getting some family therapy models for treating depression. There's lots of models for treating, you know, behavioral issues or, you know, substance abuse or so on. But some of these issues like more internalizing, you know, trauma and anxiety and so on, there's not as many models, so everybody deters to CBT or trauma focused CBT or so on.
Mary Jo Barrett, MSW: (01:01:09)
Right, and so the book is really family therapy. I, you know, I don't have the title yet, it's being written. But you know, systemic treatment of trauma, of complex trauma and how, you know, I, I don't know how I'm gonna put this in, but I do think therapy and particularly trauma therapy has been colonized. And even though I'm a white woman writing, I hope to look at it as saying, is that a real systemic model? Is considering all the social political variables as well. And how to bring that into treatment and how to bring that into family treatment. So, to me, true systemic is how so look at the family and the social political environment. So that's what the book is, is how to really look at complex trauma systemically. So that's, that's, you know, at least I, I hope I have that book left in me.
Dr. Keith Sutton, Psy.D: (01:02:33)
Yes, yes. Well, it sounds like you're doing so much wonderful work and you've really kind of been on this journey, you know, throughout, and all the way back to, like you're saying, kind of the beginning of the child abuse laws and kind of through this process and really kind of figuring it out and coming up with your own kind of blueprint and model and integrating it. It sounds like so much with the, you know, the, the neurological IFS, the polyvagal. And just to kind of circle back to the blueprint. You've talked about phase one and phase two. Is that, are there more phases?
Mary Jo Barrett, MSW: (01:03:15)
The phase, the next phase you just did as I was sitting here thinking, which is consolidation.
So just how you took the podcast. So like my husband says, I do everything in three phases and it's all cyclical. It's the same thing. You created the context by saying how you've known me, and even that I knew your mom. And so you created the context, asked me some questions, say to where we start, then we moved into challenging patterns and sort of saying, okay, so where are you at now? What's going on? What are the challenges? What are you doing? And then you just consolidate it. So, and that happens in seconds and in minutes. And for us, it just happened in 50 minutes. And that, so those are the three phases, and then consolidation is then creating the context. So there’s the three phases, but it's a cycle. So when you consolidate, then you're also creating a context for, look into more about family. You know, your old podcast is creating context.
Dr. Keith Sutton, Psy.D: (01:04:32)
Definitely. So, and then you, and it kind of keeps evolving from there. That sounds wonderful. Good. Well, thank you so much for taking the time. You know, I'm just, I love what you're doing and I love the social justice aspect that you're doing and really kind of expanding into these larger systems and you know, the work that you're doing with the gangs and, you know, just kind of also integrating a lot of these important pieces, the colonization of therapy and systemic racism and oppression and post-slavery and all these kind of pieces into this larger systemic thinking and your model. I'm really looking forward to the book. It sounds great.
Mary Jo Barrett, MSW: (01:05:18)
So the one thing I would wanna say is, you know, in this time, Keith, that we're all living in Which is pretty difficult and struggling and unknown. I would really like to tell your listeners that, I'm not saying go volunteer to make yourself feel good. I'm saying that because so many of us feel powerless and out of control and disconnected and devalued. That and feeling really powerless. Like, what can I do? I really want to share that, you know, a couple hours a week of really feeling like you're making a significant social political or, and psychological and emotional and spiritual difference in one or two lives. Where people who can't afford the great therapy that all your listeners are doing. Yet deserve all that great work. That I just really wanna encourage people that it's, you know, we all, we have to be a village right now. In this world
Dr. Keith Sutton, Psy.D: (01:06:40)
And giving of, even just like you're saying, those few hours or so on, can have a larger impact rather than some people just get so overwhelmed with there's so much and I can't change it.
Mary Jo Barrett, MSW: (01:06:50)
That’s right, I got overwhelmed
Dr. Keith Sutton, Psy.D: (01:06:52)
Just doing small acts that might build and, and keep that as part of their work.
Mary Jo Barrett, MSW: (01:06:58)
Right. I truly believe therapists have a sacred gift. I do. It's a gift. It's an art and it's a gift, and it's very sacred, and the world needs it right now.
Dr. Keith Sutton, Psy.D: (01:07:09)
Yeah. Well, thank you for giving us this gift of, you know, the work that you're doing, and thank you. It's great to hear. And I'm, you know, I'm sure you know, listeners are gonna be really, you know, inspired by this work. And thank you so much for taking the time. I really appreciate it.
Mary Jo Barrett, MSW: (01:07:27)
Thank you.
Dr. Keith Sutton, Psy.D: (01:07:28)
Okay. Take care. Bye bye.
Dr. Keith Sutton, Psy.D: (01:07:30)
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